Social determinants and the health of Indigenous Australians

Michael Marmot
Med J Aust 2011; 194 (10): 512-513.

Health is dependent on conditions that enable people to live lives they would choose to live

Inequalities in health arise from inequalities in society. Small differences in society result in small health inequalities; large differences result in large health inequalities.1 Differences in access to health care matter, as do differences in lifestyle, but the key determinants of social inequalities in health lie in the circumstances in which people are born, grow, live, work, and age. These, in turn, arise from differential access to power and resources. Such was the conclusion of the World Health Organization Commission on Social Determinants of Health (CSDH).2 The CSDH had an optimistic tone. Reviewing evidence from around the world, and reaching judgements on what works, it concluded that it is indeed possible to make great progress in closing health gaps β€” in a generation.

Please login with your free MJA account to view this article in full

  • Michael Marmot

  • University College London, London, UK.


  • 1. Marmot M. The status syndrome. New York: Henry Holt, 2004.
  • 2. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: World Health Organization, 2008.
  • 3. Calma T. Aboriginal and Torres Strait Islander Social Justice Commission. Social justice report 2005. Chapter 2. Sydney: Human Rights and Equal Opportunity Commission, 2005. (accessed Apr 2011).
  • 4. Marmot Review. Fair society, healthy lives: strategic review of health inequalities in England post 2010. London, Marmot Review, 2010.
  • 5. Coleman JJ, Spurling GK, Askew DA, Hayman NE. Indigenous child health checks: a view from the city. Med J Aust 2011; 194: 535-536. <MJA full text>
  • 6. Australian Bureau of Statistics and Australian Institute of Health and Welfare. The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples 2008. Canberra: ABS and AIHW, 2008. (ABS Cat. No. 4704.0; AIHW Cat. No. IHW 21.) (accessed Apr 2011).
  • 7. Marmot M. Social determinants of health inequalities. Lancet 2005; 365: 1099-1104.
  • 8. Dr Charles Nelson Perrurle Perkins AO, Arrernte and Kalkadoon man, 1936–2000 [extract from State Funeral program, 25 October 2000]. (accessed Apr 2011).
  • 9. Lane J. Indigenous participation in university education. Sydney: Centre for Independent Studies, 2009. (accessed Apr 2011).
  • 10. Sen A. Development as freedom. New York: Alfred A Knopf Inc, 1999.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.